Kornimate/medical-research-clean huggingface dataset:
the effect of pharyngeal packing on postoperative gastric volume in patients undergoing nasal surgery

Conditions: Anesthesia; Nasal Surgery; Pharyngeal Packing; Gastric Volume; Postoperative Nausea

Summary: pharyngeal packing is a frequently used application to reduce the incidence and severity of postoperative nausea and vomiting (ponv) in patients who undergo nasal surgery. this study aims to research the effects of pp on gastric antral cross-sectional area (acsa) and hence gastric volume as assessed by ultrasound, therewithal ponv and sore throat were evaluated as secondary outcomes in rhino logic surgeries (septorhinoplasty, septoplasty, functional endoscopic sinus surgery).

postoperative nausea and vomiting (ponv) after nasal surgery (septorhinoplasty, septoplasty, functional endoscopic sinus surgery) is a very common complication (34-60%). therefore, pharangeal packing was performed to prevent blood ingestion so as to decrease the incidence of ponv and the risk of aspiration. also, gastric blood is known to be a powerful emetic. actually, there is not any evidence in the literature reporting the quantitative values of gastric volumes due to blood ingestion. the aim of this study is to research the effect of pharyngeal packing on the perioperative gastric antral cross-sectional area (acsa) so the gastric volumes. measurements were performed by ultrasound with convex probe in right lateral decubitus position, in order to evaluate the effectiveness of pharyngeal packing in patients undergoing nasal surgery, and to show its effects on ponv and sore throat.

Eligibility criteria:
inclusion criteria: * undergoing elective nasal or paranasal sinus surgery following overnight fasting * 18-70 years of age * accepting to join the study * american society of anesthesiologist (asa) classification system i-iii * body mass index (bmi) \< 30 kg/m2 exclusion criteria: * asa classification higher than iii * age younger than 18 years * bmi\>30 kg/m2 * preoperative vomiting or antiemetic medication therapy * intubation needing more than two laryngoscopy attempts * not agreeing to participate in the study * coagulation disorders * diseases or conditions affecting gastric volume or motility
prevention of disability: proposal for a guidance manual for leprosy patients

Conditions: Leprosy; Disability Evaluation; Quality of Life

Summary: leprosy is an infectious disease of slow evolution, manifested primarily by signs and symptoms dermatoneurological with skin lesions and peripheral nerve, especially in the eyes, hands and feet. the prevention of disability is essential for the control of complications. objective: to evaluate the physical and functional status of hands, feet and eyes, for the appearance and evolution of sensory and motor deficiencies and classification of disability (who) of a group of leprosy patients to compare and monitor the result treatment on the progression of neuropathy and recurrence of reactions. methodology: we performed initial physical therapy evaluation and final, after 12 months. we conducted a clinical trial of a series of 26 cases evaluated with newly diagnosed leprosy, treated by standard medication. there were used methods of qualitative and quantitative. an illustrated manual of guidelines was especially developed for this study.

assessment methods of qualitative and quantitative: inspection of eyes, hands and foot, manual motor function, grip and pinch dynamometry,threshold test, sf 36 quality of life questionnaire. intervention: illustrated guidelines, exercises, orthoses, orientation goals: disability prevention

Eligibility criteria:
inclusion criteria: * the patients in this project were diagnosed and referred by the dermatology to do the physical-functional evaluation and physiotherapy. we selected patients aged 18 years and both sexes, even with comorbidities, since diagnosed and treated. in accepting to participate in the research, signed a consent form exclusion criteria: * those patients who refused to sign the consent form and those who did not attend the evaluations

Keywords: leprosy disability evaluation quality of life sensation
treatment of displaced lateral clavicle fractures using a locking compression plate with lateral extension

Conditions: Fracture, Closed, Comminuted, Healing

Summary: treatment of lateral fractures of the clavicle is challenging and has been controversially discussed for a long time due to high non-union rates in non-operative treatment and high complication rates in surgical treatment. a recently developed implant was proven to ensure a biomechanically sufficient fixation of fractures leading to bony union and promising functional outcome in a small collective of patients.

treatment of lateral fractures of the clavicle is challenging and has been controversially discussed for a long time due to high non-union rates in non-operative treatment and high complication rates in surgical treatment. a recently developed implant was proven to ensure a biomechanically sufficient fixation of fractures leading to bony union and promising functional outcome in a small collective of patients. in this prospective study patients with dislocated fractures of the lateral clavicle (jäger\&breitner i-iii, neer i-iii) are enrolled. all patients are surgically treated using the locking compression plate (lcp) for the superior anterior clavicle (synthes®). functional outcome is recorded using the munich shoulder questionnaire (msq) allowing for qualitative self-assessment of the shoulder pain and disability index (spadi), of the disability of the arm, shoulder and hand (dash) score and of the constant score. acromioclavicular joint stability is evaluated using the taft-score.

Eligibility criteria:
inclusion criteria: * dislocated fracture of the lateral clavicle * informed consent. exclusion criteria: * patients with a history of any other pathology such as preexisting rotator cuff tear, gleno-humeral instability, glenohumeral osteoarthritis (\> samilson i), acromioclavicular joint instability, acromioclavicular osteoarthritis, calcifying tendonitis, biceps pathology or signs of cervical root symptoms
improving quality of life for veterans with stroke and psychological distress

Conditions: Stroke; Depression; Anxiety

Summary: the study will create a treatment to improves mobility, physical activity, engagement in activities with family and friends and overall satisfaction with life for veterans who have depression and anxiety after having a stroke. the treatment will then be tested to ensure it makes the desired improvements in the veterans.

the study has three aims. the first aim is to develop a client-centered, behavioral stroke self-management program (i'm whole) for veterans with stroke and psychological distress (e.g., symptoms of anxiety and/or depression). this will be done using expert input from a multidisciplinary team of a clinical psychologist, nurse practitioner, exercise physiologist and social role functioning expert will be used to create the i'm whole patient workbook and clinician manual. the second aim is to pilot the i'm whole treatment by delivering the intervention to 5 veterans suffering from stroke and comorbid depression and/or anxiety symptoms. the feasibility (barriers and facilitators to completing i'm whole and acceptability of the intervention) will be assessed through qualitative interviews posttreatment. veterans' feedback about ways to improve i'm whole will be analyzed and used to improve treatment. the third aim is to test the feasibility and preliminary efficacy of i'm whole on quality of life (primary outcome) physical functioning, physical activity, social role functioning, psychological distress, and satisfaction with i'm whole (secondary outcomes). to test the feasibility and efficacy, a small randomized controlled trial (rct) with 30 veterans (15 i'm whole and 15 education+usual care) with stroke and psychological distress will be conducted.

Eligibility criteria:
inclusion criteria: * a documented history of stroke and/or transient ischemic attack within the last 30 days * a modified rankin score of \> 3) * regular access to a computer or tablet with internet and a camera * ability to give appropriate informed consent * score \> 5 on a measure of depression (patient health questionnaire \[phq-8\]) and/or \>17 on a measure of anxiety (generalized anxiety disorder-7 \[gad-7\]) assessments * ability to ambulate with or without assistance of a cane or walker exclusion criteria: * cognitive impairment, as evidenced by a score of \>3 on a brief cognitive screener * documented diagnosis of psychotic disorder or schizophrenia * documented severe depression, anxiety (based on phq-8 or gad-7 score of \> 20), or hospitalization for psychiatric illness within the past 30 days

Keywords: behavioral treatment telehealth stroke self-management psychological distress social integration
the effect of neuraxial morphine (duramorph) on pain control

Conditions: Perineal Tear

Summary: with the rise of the opioid epidemic, it is important for physicians to be more mindful of the amount of narcotic prescriptions that are being written every day. in the early postpartum period, pain and fatigue are the most common problems reported by women. untreated pain has negative consequences on the amount of opioid narcotics used, postpartum depression, and the potential development of persistent chronic pain. while pain can interfere with a woman's ability to adequately take care of her newborn, narcotic abuse can lead to excessive maternal drowsiness and increased infant mortality in the new breastfeeding mother. the most common sources of pain after a vaginal delivery include breast engorgement, uterine contractions and perineal lacerations. perineal lacerations are immediate postpartum complications of the vaginal birth process, defined as injury that involves the bulbocavernosum muscle complex (second degree), and may involve the anal sphincter complex (third degree) or the anal epithelium (fourth degree). prevention of chronic and severe postpartum pain, especially after a cesarean delivery has been extensively studied, however, much paucity in research exists for the management of postpartum pain from perineal tears. compared to patients with first degree tears or intact perineum, women with severe perineal lacerations (second degree or greater) have increased analgesic requirement up to the fifth postpartum day. . epidural morphine has been accepted by anesthesiologists as treatment for acute pain. in obstetrics, 2-3 mg of epidural morphine was found to be sufficient to provide post-episiotomy analgesia. neuraxial morphine has been used for analgesic management after a cesarean section, especially to reduce the amount of oral pain medications used in the first 24 hours, but limited data exists on the use of neuraxial morphine after a severe perineal laceration repair in the setting of a vaginal delivery. niv et al (1994) studied the effect of epidural morphine and monitored its timing of administration in post-epiostomy pain onset. they noted that if epidural morphine is administered before the onset of pain in an episiotomy repair it is much more effective than if given after the onset. this study hopes to take the prior 1994 study a step further and incorporates it's data to investigate whether neuraxial morphine given after a severe perineal laceration repair mitigates postpartum pain.


Eligibility criteria:
inclusion criteria: * patients with a second degree, third degree, or fourth degree perineal tear identified in the immediate postpartum period. * pregnant patients who received neuraxial anesthesia during their labor course * women \>18 yo exclusion criteria: * unwillingness to participate in the study * allergy to morphine * women with history of polysubstance abuse/narcotic abuse * women \<18 yo
study of olfactory disorders in patients with cardiac amyloidosis

Conditions: Amyloidosis; Cardiac Amyloidosis; Olfactory Loss; Hyposmia; Dysosmia; Smell Disorders; Taste Disorders

Summary: amyloidosis is a disease caused by the continuous accumulation of fibrillary proteins in the extracellular matrix causing the architecture of different organs to be disrupted. the prevalence of the disease increases with age. the two most common forms are light chain amyloidosis (al) and transthyretin (ttr). ttr amyloidosis may be hereditary (m-ttr, or mutated) or age-related (wt-ttr, or wild). the latter is also called senile amyloidosis. in all these forms, cardiac impairment is common and leads the patient to consult/or be referred to a cardiological center unfortunately often too late when the prognosis is directly related to the severity of the heart attack. the description/discovery of clinical signs prior to heart disease is important to improve the detection and diagnosis of early forms of cardiac amyloidosis (ca). for example, an infiltration of the carpal tunnel synovial by amyloid deposits is observed in some patients, 5 years before the onset of signs of heart failure and is the only warning sign of the disease known to date. we also showed in a previous study that patients had more severe and earlier impairment of hearing function than expected by age and gender. objective the main objective is to define the prevalence and severity of smell and taste disorders in a population of patients with cardiac amyloidosis (3 types of mutated or wild al amyloidosis and ttr). the main endpoint is to determine the number of patients with impaired smell and taste's functions in a population of patients diagnosed with cardiac amyloidosis (3 types of mutated (hereditary) or senile wild amyloidosis (3 types of al amyloidosis and ttr). method successive monocentric cross-sectional study on the screening of smell and taste disorders carried out as part of a cardiology hospitalization programmed for the cardiology follow-up of his pathology in a population of patients diagnosed with ac.


Eligibility criteria:
inclusion criteria: * age\>18 years * affiliated with social security * patient who was informed of the study and signed a free and informed consent * patients diagnosed with ac exclusion criteria: * - refusal to participate in the study * patient who does not speak or understand french * history of chronic rhino sinusitis with or without polyps * a history of counter-indicating the completion of nasal endoscopy (repeated epistaxis, obstructive naso-sinusal tumors, choanal imperforation) * history of major craniofacial trauma resulting in loss of smell * known history of parkinson's disease or alzheimer's disease * antecedent of ent radiotherapy * history of chemotherapy * patient under guardianship, curatorship or legal protection * patient on ame * pregnant or lactating women

Keywords: amyloidosis cardiac amyloidosis olfactory loss hyposmia dysosmia smell disorders taste disorders
use of low-level laser therapy (808nm) to muscle fatigue resistance

Conditions: Healthy

Summary: the study hypothesis is a improved muscle fatigue resistance induced by low-level laser therapy applied between sets of intense exercises.


Eligibility criteria:
inclusion criteria: * healthy males * physically active * aged between 18-28 years old exclusion criteria: * smoker * under medicine * lower limb lesions limiting the flexion-extension of the knee joint

Keywords: low-level laser therapy muscle fatigue resistance
buffered vs. unbuffered local anesthesia in mandibular molars diagnosed with symptomatic irreversible pulpitis

Conditions: Symptomatic Irreversible Pulpitis

Summary: the purpose of this study is to determine whether one type of anesthetic (numbing medicine) will work better at numbing the nerve in a tooth than using a different type of anesthetic. a second purpose is to see if the time needed to numb the nerve in a tooth is different between the two anesthetics.

40 subjects with a mandibular molar diagnosed with symptomatic irreversible pulpitis will be randomly allocated into 2 groups. one group will receive a total of 3 cartridges of a standard, unbuffered 2% lidocaine with 1:100,000 epinephrine via inferior alveolar nerve block (ianb) followed by supplemental buccal and lingual infiltrations, while the other will receive the equivalent yet buffered formulation. an electronic pulp tester (ept) will be used to objectively determine baseline pulpal status of the affected tooth, followed by 2-minute interval testing following the administration of all local anesthesia. the onset of pulpal anesthesia is defined by the first of 2 consecutive ept=80 readings, and the endodontic treatment may begin. profound pulpal anesthesia is ultimately determined if the patients report a comfortable pulpotomy as reflected on the wong-baker faces visual analog scale.

Eligibility criteria:
inclusion criteria - in order to participate, subjects must: * be between the ages of 18 and 80 years old * have the ability and willingness to independently consent to treatment and study participation * have an uncomplicated medical history (asa i and ii) * not be pregnant * have no allergies local anesthetics/sulfites (confirmed or self-reported) * not be taking any medications that may affect the proper assessment of the anesthetic (no acetaminophen or short-acting nsaids such as ibuprofen within the previous 6 hours; no long-acting nsaids such as naproxen within the previous 16 hours) * not require nitrous oxide during treatment, and the injection area should appear healthy with no other pre-existing conditions or infections that may compromise an accurate collection of data * be experiencing signs of irreversible pulpitis (an exaggerated response to cold that lingers longer than 10 seconds) in a mandibular molar at the time of conducting the study exclusion criteria - no subjects will have: * a negative response to cold in the proposed treatment tooth * a radiographic periradicular pathosis more advanced than a widened periodontal ligament or have an intraoral swelling

Keywords: lidocaine buffered local anesthetic irreversible pulpitis
a study on application of adjustable headrest in painless curettage surgery for overweight and obese patients

Conditions: Adjustable Headrests; Ventilation Function; Obese Patients

Summary: the aim of this study is to observe the effect of adjustable headrests on ventilation function in overweight and obese patients through clinical experiments, and to explore the impact on the incidence of hypoxemia during painless curettage in overweight and obese patients. participants will be randomly allocated to three groups: the supine head-straight position group(group a), the supine head-lateral position group(group b), and the adjustable headrest group(group c). these three groups of patients underwent painless curettage surgery in the daytime operating room and the occurrence of hypoxemia will be observed.


Eligibility criteria:
inclusion criteria: * patients who choose to have painless surgical abortion * body mass index greater than 24 * the american society of anesthesiologists (asa) physical status ranked i-ii * competent to provide informed consent exclusion criteria: * abnormal lung function or respiratory system diseases * airway obstruction or respiratory malformation * cervical spondylosis * psychiatric disorders
effect of cpap treatment in elderly: randomized clinical trial

Conditions: Sleep Apnea, Obstructive

Summary: rationale: almost all the information the investigators have about the effect of continuous positive airway pressure (cpap) in patients with obstructive sleep apnea (osa) comes from randomized clinical trials including only middle-aged patients. little is know, however, about the effect of cpap in elderly people with osa. objective: to assess the effect of cpap treatment in elderly patients with severe osa on clinical, quality-of-life and neurocognitive spheres. methods and measurements: open-label, randomized, multicenter clinical trial of parallel groups with blinded end-point design conducted in 12 spanish teaching hospitals on a consecutive clinical cohort of elderly (≥ 70 years) patients with confirmed severe osa (iah≥ 30) receiving cpap or no therapy while maintaining their usual control for three months. cpap titration was performed by an auto cpap device. a good adherence was set as at least 4 hours/day of cpap use. primary endpoint was the measurement of quality of life by the quebec sleep questionnaire, which includes diurnal and nocturnal symptoms, hypersomnolence, and social and emotional dimensions. secondary endpoints include different sleep-related symptoms, presence of anxiety or depression, office blood pressure figures and some neurocognitive tests. patients were invited to a clinical visit on three occasions to quantify the adherence to cpap. intention-to-treat analysis was performed.

not needed

Eligibility criteria:
inclusion criteria: * patients were initially eligible for participation in the study if they were aged at least 70 years, had an apnea-hypopnea index (ahi) ≥30 and had signed the informed consent to participate exclusion criteria: * current use of cpap treatment, central sleep apnea (defined as at least 50% of respiratory events having a pattern of apnea or hypopnea without respiratory effort), respiratory failure (defined as diurnal oxygen saturation below 90%), severe heart failure (nyha iii-iv), a cardiovascular event in the month prior to the inclusion in the study or disabling hypersomnia requiring urgent treatment (defined as an epworth sleepiness scale ≥ 18).

Keywords: elderly cpap clinical trial obstructive sleep apnea
patient education at dismissal after surgical procedure

Conditions: Wound Infection Post-Traumatic; Wound Infection; Wound Complication; Wound Breakdown; Wound Open

Summary: can improvements in patient dismissal education materials reduce incidence of wound non-healing and infection.

the investigators seek to address the specific educational needs of patients and caregivers with low-literacy, dyslexia and related learning disabilities in the context of properly performing wound care for patients with surgical wounds. specific aims include both improving care by decreasing wound complications and improving patient satisfaction by using techniques designed for this population. objectives include utilizing surveys to determine the incidence of dyslexia among the patients' and caregivers' within the general surgery service as well as the perception of our current educational offerings, to design a new dismissal package with enhanced educational offerings, to re-measure this effect on the patient experience with survey data, and to compare wound infection rates before and after implementing the new curriculum. dyslexia and associated learning disabilities are common and likely impact the health literacy among this population due to the ubiquitous literacy-based documentation of hospital course and dismissal instructions. adults with dyslexia may be reluctant to disclose any inability to understand written instructions. there is currently no mechanism within the dismissal system to specifically identify and address the unique needs of this population. the impact on clinical outcomes of proper wound packing is substantial, and if performed incorrectly can lead to slow wound healing and infections that often require readmission, multiple courses of antibiotics, and reoperation. in severe cases, improper wound care can lead to severe infection, sepsis, and death. by enhancing the educational offerings of proper wound care to this population, the investigators hope to reduce these complications.

Eligibility criteria:
inclusion criteria: * adult patients on the general surgery service with open wounds requiring packing exclusion criteria: * patients with wound vacs * patients receiving exclusively professional wound care or home health services